Journals / SDÜ Tıp Fakültesi Dergisi / 2026 / Cilt: 31 Sayı: 1

THE EFFECT OF VOLUME STATUS ON QUALITY OF LIFE, ANXIETY, DEPRESSION AND SLEEP QUALITY IN HEMODIALYSIS PATIENTS

HEMODİYALİZ HASTALARINDA VOLÜM DURUMUNUN YAŞAM KALİTESİ, ANKSİYETE, DEPRESYON VE UYKU KALİTESİ ÜZERİNE ETKİSİ

Selma Özlem Çelikdelen(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ KONYA ŞEHİR HASTANESİ)0009-0000-8546-0070
Pages
71–79
Publication Date
2024-03-18
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Considering the impact of all these factors on patients’ morbidity and survival, it is important to determine volume status and dry weight in patients undergoing hemodialysis.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives To determine the volume status of patients undergoing hemodialysis using the bioimpedance method and to investigate the relationship of volume status with the patients’ quality of life, anxiety, depression, and sleep quality.
📊
Key Findings & Data:Material and Method This cross-sectional study included a total of 100 patients undergoing hemodialysis at the Hemodialysis Unit in March 2016.
💡
Conclusion & Impact:Considering the impact of all these factors on patients’ morbidity and survival, it is important to determine volume status and dry weight in patients undergoing hemodialysis.
🔬Design:Survey & Empirical Study
📍Scope:2016 Verileri
⚙️Variables:hemodiyaliz · biyoimpedans · yaşam kalitesi

Abstract

Objectives To determine the volume status of patients undergoing hemodialysis using the bioimpedance method and to investigate the relationship of volume status with the patients’ quality of life, anxiety, depression, and sleep quality. Material and Method This cross-sectional study included a total of 100 patients undergoing hemodialysis at the Hemodialysis Unit in March 2016. The volume status of the patients was determined using bioelectrical impedance analysis (BIA) performed with a body composition monitor before their mid-week hemodialysis sessions. The quality of life was evaluated using the 36-item Short Form Survey, sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI), depression screening was performed with the Beck Depression Inventory, and anxiety screening was undertaken with the Beck Anxiety Inventory. The patients were divided into three groups according to the extracellular fluid/ total body fluid (ECF/TBF) ratio, which is one of the BIA parameters: Group 1, <25th percentile (ECF/ TBF<0.426 L, n=24); Group 2, 25-50th percentile (ECF/TBF: 0.426-0.438 L, n=37); and Group 3, 50- 75th percentile (ECF/TBF: 0.438-0.481 L, n=39). Statistical analyses were performed for the three groups. Results The ECF/TBF ratio was found to be higher in female patients, individuals who lived alone, and those with a low educational level. As the ECF/TBF ratio increased, there was a deterioration in the physical and mental components of quality of life, including physical functioning (p<0.001), physical role difficulties (p=0.03), general health perceptions (p=0.03), mental component (p=0.02), mental health (p=0.01), social functioning (p<0.001), and vitality (p=0.01). The rate of depression was 40% in all patients, 25% in Group 1, 43% in Group 2, and 45% in Group 3. As the ECF/TBF ratio increased, a statistically non-significant increase was observed in depression scores. The PSQI total score was found to be above 5 in all patients included in the study. Conclusion It was determined that as the ECF/TBF ratio increased in hemodialysis patients, the quality of life decreased, depression and anxiety symptoms increased, sleep quality deteriorated, sleep efficiency decreased, and sleep duration was shortened. Considering the impact of all these factors on patients’ morbidity and survival, it is important to determine volume status and dry weight in patients undergoing hemodialysis.

Özet

Amaç Çalışmada hemodiyalize girmekte olan hastaların biyoimpedans yöntemi ile volüm durumlarının belirlenmesi ve volüm durumunun hastaların yaşam kalitesi, anksiyete, depresyon ve uyku kalitesi ile ilişkisinin araştırılması amaçlandı. Gereç ve Yöntem Kesitsel olarak planlanan çalışmaya 2016 Yılı Mart Ayı’nda Hemodiyaliz Ünitesinde hemodiyalize girmekte olan toplam 100 hasta alındı. Hastaların volüm durumunu belirlemek için, hafta ortası hemodiyaliz seansları öncesinde vücut kompozisyon monitörü ile biyoelektriksel impedans analizi (BİA) yapıldı. Hastaların yaşam kaliteleri SF-36 yaşam kalitesi ölçeği ile, uyku kalitesi Pittsburg Uyku Kalitesi İndeksi (PUKİ) kullanılarak, depresyon taramaları Beck Depresyon Ölçeği (BDÖ), anksiyete taramaları Beck Anksiyete Ölçeği ile değerlendirildi. Hastalar BİA parametrelerinden hücre dışı sıvı/ total vücut sıvısı (HDS/TVS) oranlarına göre üç gruba ayrıldı. Grup1; <25 persentil (HDS/TVS<0,426 Lt, n=24), grup 2; 25-50 persentil (HDS/TVS: 0,426-0,438 Lt, n=37), grup 3; 50-75 persentil (HDS/TVS: 0,438-0,481 Lt, n=39). İstatiksel analizler üç grup üzerinden yapıldı. Bulgular Kadın cinsiyette, yalnız yaşayan ve eğitim seviyesi düşük olan hastalarda HDS/TVS oranları yüksek bulundu. HDS/TVS oranı arttıkça, yaşam kalitesi komponentlerinden; fiziksel komponent (p=0,01) ve mental komponentte (p=0,02) bozulma olduğu; fiziksel komponent bileşenlerinden; fiziksel fonksiyon (p<0,001), fiziksel rol güçlüğü (p=0,03), genel sağlık algısında (p=0,03) azalma, mental komponent bileşenlerinden; mental sağlık (p=0,01), sosyal fonksiyon (p<0,001) ve vitalite (p=0,01) alanlarında bozulma olduğu görüldü. Tüm hastalarda depresyon oranı %40, gruplar kendi içinde değerlendirildiğinde depresyon oranı grup 1’de %25, grup 2’de %43 ve grup 3’de %45 olarak tespit edildi. HDS/TVS oranı arttıkça, depresyon skorlarında istatiksel anlamlı olmayan bir artış izlendi. Çalışmaya alınan hastaların tamamında PUKİ total skoru 5’in üstünde saptandı. Sonuç Çalışma sonucunda, HD hastalarında HDS/TVS oranı arttıkça, yaşam kalitesinin azaldığı, depresyon ve anksiyete bulgularının arttığı, uyku kalitesinin bozulduğu, uyku veriminin azaldığı ve uyku süresinin kısaldığını saptadık. Tüm bu faktörlerin, hastaların morbidite ve sağkalımına etkisi göz önüne alındığında, HD hastalarında volüm kontrolü ve kuru ağırlık tespiti önemlidir.

🔖

Cite This Article

Çelikdelen, S. Ö. (2024). THE EFFECT OF VOLUME STATUS ON QUALITY OF LIFE, ANXIETY, DEPRESSION AND SLEEP QUALITY IN HEMODIALYSIS PATIENTS. SDÜ Tıp Fakültesi Dergisi, Cilt: 31 Sayı: 1, 71–79. https://doi.org/10.17343/sdutfd.1401138

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (34)

  1. Crews DC, Bello AK, Saadi G. Burden, access, and disparities in kidney disease. Blood Purif 2019;48(1):32-39.
  2. Kassebaum NJ, Arora M, Barber RM, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990– 2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 2016;388.10053:1603-1658.
  3. Ateş K, Süleymanlar G, Nurhan S. Türkiye'de nefroloji, diyaliz ve transplantasyon registry 2018. TC Sağlık Bakanlığı ve Türk Nefroloji Derneği Ortak Raporu, 2019.
  4. Zhu F, Wystrychowski G, Kitzler T, et al. Application of bioimpedance techniques to peritoneal dialysis. Contrib Nephrol 2006;150:119-128.
  5. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. Kısa form-36 (SF- 36)’nın Türkçe versiyonunun güvenirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12:102-106.
  6. Liem YS, Bosch JL, Arends LR, et al. Quality of life assessed with the medical outcomes study short form 36-item health survey of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 2007;10(5):390-7.
  7. Buysse DJ, Reynolds CF, Monk TF, et al. The Pittsburgh sleep quality index: A new instrument psychiatric practice and research. Psychiatry Res 1989;28:193-213.
  8. Ağargün MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi İndeksinin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi 1996;7:107- 15.
  9. Fiorentini A, Valente R, Perciaccante A, et al. Sleep's quality disorders in patients with hypertension and type 2 diabetes mellitus. Int J Cardiol 2007;8;114(2):50-2.
  10. Hisli N. Beck Depresyon Envanterinin geçerliliği üzerine bir çalışma (A study on the validity of Beck Depression Inventory.). Psikoloji Dergisi 1988;6:118-122.
  11. Ulusoy M, Şahin N, Erkmen H. Turkish version of Beck Anxiety inventory: Psychometric properties. Journal of cognitive psychotherapy 1998;12(2):163.
  12. Onofriescu M, Hogas S, Voroneanu L, et al. Bioimpedance-guided fluid management in maintenance hemodialysis: a pilot randomized controlled trial. Am J Kidney Dis 2014;64(1):111-8.
  13. Chan C, McIntyre C, Smith D, Spanel P, Davies SJ. Combining near-subject absolute and relative measures of longitudinal hydration in hemodialysis. Clin J Am Soc Nephrol 2009;4(11):1791-8.
  14. Devolder I, Verleysen A, Vijt D, et al. Body composition, hydration, and related parameters in hemodialysis versus peritoneal dialysis patients. Perit Dial Int 2010;30(2):208-14.
  15. Crepaldi C, Soni S, Chionh CY, et al. Application of body composition monitoring to peritoneal dialysis patients. Contrib Nephrol 2009;163:1-6.
  16. Beberashvili I, Azar A, Sinuani I, et al. Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients. Eur J Clin Nutr 2014;68(6):683-9.
  17. Jacobs LH, van de Kerkhof JJ, Mingels AM, et al. Inflammation, overhydration and cardiac biomarkers in haemodialysis patients: a longitudinal study. Nephrol Dial Transplant 2010;25(1):243-8.
  18. Park J, Chung HC, Kim MS, et al. Relationship between extracellular water fraction of total body water estimated by bioimpedance spectroscopy and cardiac troponin T in chronic haemodialysis patients. Blood Purif 2009;28(1):61-8.
  19. Onofriescu M, Hogas S, Voroneanu L, et al. Bioimpedanceguided fluid management in maintenance hemodialysis: a pilot randomized controlled trial. Am J Kidney Dis 2014;64(1):111-8.
  20. Voroneanu L, Cusai C, Hogas S, et al. The relationship between chronic volume overload and elevated blood pressure in hemodialysis patients: use of bioimpedance provides a different perspective from echocardiography and biomarker methodologies. Int Urol Nephrol 2010;42(3):789-97.
  21. Avramovic M, Stefanovic V. Health-related quality of life in different stages of renal failure. Artif Organs 2012;36(7):581-9.
  22. Morch CM, Gonçatves LF, Barros E. Health related quality of life among haemodialysis patients-relationship with clinical indicators, morbidity and mortality. J Clin Nurs 2006;15(4):498-504.
  23. Gayle F, Soyibo AK, Gilbert DT, et al. Quality of life in end stage renal disease: a multicentre comparative study. West Indian Med J 2009;58(3):235-42.7
  24. Hinrichsen GA, Lieberman JA, Pollack S, et al. Depression in hemodialysis patients. Psychosomatics 1989;30(3):284-9.
  25. Kimmel PL. Psychosocial factors in dialysis patients. Kidney Int 2001;59(4):1599-613.
  26. Kimmel PL, Weihs KL, Peterson RA. Survival in hemodialysis patients: the role of depression. J Am Soc Nephrol 1993;4(1):12-27.
  27. Hedayati SS, Bosworth H, Briley L, et al. Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int 2008;74(7):930-6.
  28. Kimmel PL. Depression in patients with chronic renal disease: what we know and what we need to know. J Psychosom Res 2002;53(4):951-6.
  29. Friend R, Hatchett L, Wadhwa NK, et al. Serum albumin and depression in end-stage renal disease. Adv Perit Dial. 1997;13:155-7.
  30. Levy J. Morgan J, Brown E. Oxford Diyaliz El Kitabı. Uslan İ (Çeviren). İstanbul: Nobel Tıp Kitabevleri, 2002;135-153.
  31. Veiga J, Goncalves N, Gomes F. Sleep disturbances in end-stage renal disease patients on hemodialysis. Dial Transplant 1997;26:380-4.
  32. Holley JL, Nespor S, Rault R. A comparison of reported sleep disorders in patients on chronic hemodialysis and continuous peritoneal dialysis. Am J Kidney Dis 1992;19(2):156-61.
  33. Mendelson WB, Wadhwa NK, Greenberg HE, et al. Effects of hemodialysis on sleep apnea syndrome in endstage renal disease. Clin Nephrol 1990;33(5): 247-51.
  34. Millman RP, Kimmel PL, Shore ET, et al. Sleep apnea in hemodialysis patients: the lack of testosterone effect on its pathogenesis. Nephron 1985;40(4):407-10. 35. Sabbatini M, Minale B, Crispo A, et al. Insomnia in maintenance haemodialysis patients. Nephrol Dial Transplant 2002;17(5):852-6. 36. Iliescu EA, Coo H, McMurray MH, et al. Quality of sleep and health-related quality of life in haemodialysis patients. Nephrol Dial Transplant 2003;18(1):126-32. 37. Köktürk O. Uykunun izlenmesi. Polisomnografi. Tüberk Toraks 1999;47:499-511. 38. Kimmel PL, Miller G, Mendelson WB. Sleep apnea syndrome in chronic renal disease. Am J Med 1989;86(3):308-14.